Sunday, 26 April 2020

COVID-19 VACCINE UNLIKLEY UNTIL MID 2021 FORMER DEPUTY ENGLAND CHIEF MEDICAL OFFICER WARNS

UPDATED LINKS: A coronavirus vaccine is unlikely to be ready until “well into the next year”, the former deputy chief medical officer for England warned this morning. Professor Gina Radford urged people to be “realistic” about the possibility of a vaccine. She told Sky News’ Sophie Ridge on Sunday show: “Firstly we haven't at the moment got a vaccine so we are having to start from scratch. “We haven't got a hugely good track record with vaccines for this particular virus, coronavirus, the family of viruses. “But having said that everything is being thrown at it, there are researchers all over the world trying to identify a vaccine. “We have never seen anything like the effort that is being put to discover this vaccine.”
Closed: The Bray To Greystones Cliff Walk
County Wicklow Ireland.
She said even after discovery there was a “huge process” of testing to ensure vaccines were safe and effective. “I think those who are very used to the process of developing vaccines are saying they are not anticipating it being available until well into next year,” she said. On Friday, England’s chief medical officer Chris Whitty told MPs on the science and technology committee the probability of having an effective vaccine in the next 12 months was “incredibly small”. He said instead the UK would have to rely on social distancing measures.
https://www.irishexaminer.com/breakingnews/ireland/75-nursing-homes-need-intensive-support-during-covid-19-crisis-996144.html 

 https://www.thetimes.co.uk/edition/news/coronavirus-kremlinesque-how-the-government-tried-to-dismiss-sunday-times-report-bt9dpjmjf 

 https://www.msn.com/en-gb/news/coronavirus/coronavirus-dominic-raab-says-lifting-lockdown-too-soon-could-mean-second-spike-of-virus/ar-BB13dvtu?ocid=spartandhp 

 https://www.thetimes.co.uk/edition/news/tory-grandees-tell-pm-its-time-to-ease-the-coronavirus-lockdown-dsc593ktm 
Prof Radford said she anticipated that the lockdown would eventually be lifted in stages. She said: “They [the government] will be looking at what is going on in the rest of Europe and the rest of world, who are ahead of us in terms of the epidemic curve. “We have seen for example, what tends to happen is small businesses being opened first, if they can safely socially distance. “So whether we would look at different types of business, maybe also different parts of the country.” In regard to how schools could reopen, she said: “Maybe reduce the numbers in the class, maybe have some classes going back one week and other classes going back another week, and their schooling being supplemented by continuing with online classes.”

Dr Rosena Allin-Khan, the shadow minister for mental health, urged the government to detail plans for easing lockdown measures. She said: “The British public have shown incredible resolve, they can get through anything, but the government needs to make it slightly easier to ease the pressure on people’s families so that they understand what the easing of restrictions may look like — and that is what the Labour Party is calling for.”

She told the same Sky programme that the UK had not acted quickly enough. She said: “I understand that this is a global pandemic. It would have been impossible to save all of the lives that we've lost, but we did enter into lockdown too late. “We did not deliver PPE to the front line when it was needed, we did not follow global advice on self-isolation and we haven't rolled out mass testing and contact tracing. “So when I find myself in the unenviable position of not being able to hug someone as they cry after they've said their last goodbye it makes me think how many of these grieving families could not have had to be in this position? “And fundamentally we are going to have real mental health issues to deal with for these grieving families, but for the NHS workers who have had to hold their hands through this process.”

Additional TEXT:

Intensive care units across the country (THE UK) are running out of essentials, including anaesthetics and drugs for anxiety and blood pressure, after a “tripling of demand” sparked by the coronavirus pandemic.

Doctors said they were being forced to use alternatives to their “drug of choice”, affecting the quality of care being provided to Covid-19 patients. They also warned that some second-choice drugs might be triggering dangerous side effects such as minor heart attacks. The government is rushing to shore up supplies of vital medicines and on Thursday banned 33 drugs from export. Ministers have now ordered a “parallel export” ban on 196 essential drugs — up from 34 a month ago. It is by far the largest number since the government began compiling the list to stave off shortages in the run-up to Brexit.

Parallel exporting is when companies buy medicines meant for UK patients and sell them on in another country, potentially causing or aggravating supply problems. Companies that flout the ban risk having their trading licences revoked. The government faces mounting criticism for failing to act early enough to ensure that the NHS had the resources to save the lives of thousands of people. This month Matt Hancock, the health secretary, said the government was “confident” that the UK had the medicines it needed.

Six senior NHS doctors working on the front line and drugs industry sources say that the health service is running out of at least eight crucial drugs. Hospitals in London, Birmingham and the northwest of England have been especially badly hit. Ron Daniels, an intensive care consultant in the West Midlands, said the shortages had become “acute” already. “We don’t know what we’re going to run out of next week,” he said. “Safety isn’t so much the issue — it’s quality. It may be that we’re subjecting people to longer periods of ventilation than we would normally because the drugs take longer to wear off.” Daniels added that some of the “second-line drugs” being used might be challenging to a patient’s heart: “We might be causing small heart attacks or subclinical heart attacks.”

Drugs in short supply include: propofol, a sedative given to those on ventilation; fentanyl and alfentanil, two opioid painkillers used as part of the sedative cocktail in intensive care; and noradrenaline and clonidine, used to treat life-threateningly low blood pressure. There were “limited supplies” of atracurium, cisatracurium and rocuronium, all muscle relaxants used during intubation — when patients are sedated and put on a ventilator to help them breathe. Stocks of blood pressure drugs were under strain, he said: “We would normally use noradrenaline to deal with shock, to increase blood pressure, and we’re having to use alternatives. “We’re using vasopressin, which is normally a second-line drug, and adrenaline, which is far less suitable because it carries worse side effects.”

Many recovering Covid-19 patients were suffering from anxiety, Daniels added: “We tend to use a drug called clonidine that is normally given by intravenous infusion, but we’re running out of intravenous supplies and so we’re having to give it by crushed tablet form into the gut, which is not as effective.”

A three-page alert notice sent to NHS medical directors warned that there were “limited supplies” of the muscle relaxants rocuronium, cisatracurium and atracurium. NHS England was managing supplies of these drugs “centrally”, the notice said. Daniels added: “We’re using muscle relaxant drugs that I haven’t used for 20 years, such aa pancuronium.” Ravi Mahajan, president of the Royal College of Anaesthetists, said work was being carried out to “preserve” key drugs for those most in need. “The high numbers of Covid-positive patients needing critical care are increasing the demand for drugs used in anaesthesia and critical care,” he said. “We have developed clinical guidance which helps to conserve supplies, switch to alternatives when required and minimise waste.”

Most of the treatments on the export ban list are needed in intensive care but other drugs in high demand, notably insulin and paracetamol, are also being reserved for UK use. Several doctors warned about falling supplies of the painkiller diamorphine, often given to cancer patients. The drug is being given to Covid-19 patients to reduce breathlessness. Ministers have banned the export of at least three drugs being tested to treat the virus. They are ritonavir/lopinavir, an HIV treatment, and hydroxychloroquine and chloroquine, both used for preventing malaria. The latter two have been thrust into the spotlight by claims made by President Donald Trump, although there is no evidence that they are effective.

Daniels said the shortages had not been predictable. “No one has had to deal with a tripling of demand for these drugs before. We’ve got 2½ to three times the number of ventilated patients compared to normal.” The government was “doing everything we can” to ensure that patients “continue to access the medicines they need”, the Department of Health and Social Care said. “We know how distressing shortages can be, but we want to assure people that we have well-established processes to manage and mitigate supply problems so that patients continue to receive the high-quality care they expect.”

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